Children's venipuncture pain: influence of technical factors

Impact of cooling diabetic patients' fingertips compared to vibrating stimulation on pain from the glucometer needle: A cross-over trial study

INTRODUCTION

Blood glucose measurements using glucometers can cause discomfort due to needle insertion. Implementing effective pain management strategies is essential to alleviate this discomfort. This study aimed to evaluate the effects of cold and vibration stimulation on pain perception during glucometer needle insertion in diabetic patients.

METHODS

Sixty diabetic inpatients from Shahid Beheshti Hospital in Hamadan, Iran, participated in a crossover study, comprising 3 individuals with type 1 diabetes and 57 with type 2 diabetes. The cohort included 40 males and 20 females, with ages ranging from 18 to 70 years and a mean age of 55.7 years. The average duration of diabetes was 10 years. The study design consisted of six blocks, each containing three interventions: vibration stimulation (A), cold therapy (B), and a combination of both C. The sequences of interventions (ABC, ACB, BCA, BAC, CBA, and CAB) were randomly assigned. Each participant received the interventions at three different times: before breakfast, one to two hours after lunch, and at dinner. One hand was randomly selected for the intervention, while the other served as a control, with only the needle inserted. Pain levels were assessed using the Numeric Rating Scale (NRS) for both hands.

RESULTS

Participants receiving vibration stimulation in one hand reported a significant reduction in pain intensity, with a mean difference of 1.21 (p < 0.001) compared to the control hand. In contrast, cold therapy did not significantly affect pain intensity, showing a mean difference of only 0.06 (p > 0.05). The combination of vibration and cold therapy also did not significantly alter pain intensity, yielding a mean difference of 0.33 (p > 0.05). A significant difference (p = 0.002) was noted among the interventions, indicating varying effects on pain intensity.

CONCLUSION

Vibration stimulation effectively reduces pain associated with glucometer needle insertions. Among the methods examined, vibration stimulation proved to be the most effective for minimizing needle pain. Clinicians are encouraged to incorporate this technique into the care of diabetic patients to enhance their comfort during glucose monitoring.

Effect of Transcutaneous Electrical Nerve Stimulation on the Pain Intensity During Insertion of Needle in Patients Undergoing Spinal Anesthesia: A Randomized Controlled Study

BACKGROUND AND OBJECTIVES

Needle insertion pain during spinal anesthesia is an unpleasant experience for patients. This study aimed to investigate the effects of Transcutaneous Electrical Nerve Stimulation (TENS) on the pain intensity during the insertion of spinal needles in patients undergoing spinal anesthesia.

MATERIALS AND METHODS

In a double-blind clinical trial, 60 candidates for elective Trans Ureteral Lithotripsy surgery under spinal anesthesia were randomly divided into intervention and control groups. The electrodes of the TENS device were placed in the space between L3-L4 and L5-S1 vertebrae. The intensity of pain during insertion of the spinal needle by Visual Analog Scale and the frequency of attempts were recorded.

RESULTS

The mean age of the study samples was 34.26 ± 5.07 and 32.8 ± 5.28 in the control and intervention group, respectively. The pain intensity during insertion of spinal needles was less significant in the intervention group compared to the control group (p = 0.001). The number of attempts to insert the spinal needle between the two groups was not statistically significant (p = 0.51). The duration of spinal anesthesia implementation procedure by physician in the intervention group was significantly shorter than that of the control group (p = 0.001).

CONCLUSION

The use of TENS effectively reduced the pain of spinal needle insertion. Considering these beneficial effects, it is suggested that this procedure be used to relive pain in patients with spinal anesthesia.

Use of a phlebotomy service in a paediatric unit

This article evaluates the literature and research concerning venepuncture and the use of a phlebotomy service in an acute paediatric setting. It also highlights concerns expressed by nursing and medical staff about the introduction of such a service.

Nursing uniform preferences of parents and children in a paediatric setting

There is a growing movement towards more casual uniforms within paediatric nursing. However, children's and parents' preferences should be considered before deciding what type nurses should be wearing.